API end point: https://fhir.careevolution.com/Master.Adapter1.WebClient/api/fhir-r4.

Resource Coverage (R4)

Maps the CareEvolution Insurance concept

• Supported interactions
• Search parameters
• Sorts
• Includes
• Operations
• To FHIR mappings
• From FHIR mappings

Supported interactions

• read
• search
• create
• update
• delete

Search parameters

Name	Type	Modifiers , prefixes	Multiple values	Can be chained	Description
_id	Token		Yes		Resource id
_lastUpdated	Date	eq ne lt le gt ge sa eb ap			When the resource last changed
_source	Uri	:missing	Yes		Where the resource comes from
beneficiary	Reference (Patient)	:missing	Yes	Yes	The patient the Coverage is about. Functionally identical to the "patient" search parameter.
dependent	String	:contains :exact	Yes		Dependent number
group	String	:contains :exact :missing	Yes		Group identifier (as in DSTU2/STU3 Coverage)
identifier	Token	:missing	Yes		The primary identifier of the insured and the coverage
patient	Reference (Patient)	:missing	Yes	Yes	The patient the Coverage is about
plan	String	:contains :exact :missing	Yes		A plan or policy identifier (as in DSTU2/STU3 Coverage)
provenance-agent	Reference (Organization)	:missing	Yes	Yes	Search by provenance, specified by its author (aka originator) Organization
sequence	String	:contains :exact	Yes		Sequence number (as in DSTU2/STU3 Coverage)
subplan	String	:contains :exact :missing	Yes		Sub-plan identifier (as in DSTU2/STU3 Coverage)
type	Token	:not :in :not-in :missing	Yes		The kind of coverage (health plan, auto, Workers Compensation)

Sorts

• _id
• plan
• type

Supports multiple sorts

Includes

• beneficiary
• patient
• provenance-agent
• ExplanationOfBenefit:coverage
• Provenance:target

Operations

• validate - Validate a resource

To FHIR mappings

CareEvolution	FHIR
AuthorizationDate	extension('http://careevolution.com/fhirextensions#coverage-authorizationDate')
AuthorizationNumber	extension('http://careevolution.com/fhirextensions#coverage-authorizationNumber')
AuthorizationSource	extension('http://careevolution.com/fhirextensions#coverage-authorizationSource')
Class Domain: InsuranceClass	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|class
Comment	text
DataSource	extension('http://careevolution.com/fhirextensions#dataSource')
Details	extension('http://careevolution.com/fhirextensions#coverage-details')
EncounterID	extension('http://careevolution.com/fhirextensions#coverage-encounterID')
EndDate	period
GroupEmpId	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|subplan
GroupEmpName	extension('http://careevolution.com/fhirextensions#coverage-groupEmpName')
GroupName	extension('http://careevolution.com/fhirextensions#coverage-groupName')
	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|subgroup
GroupNumber	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|group
InsuranceCompanyAddress	payor
InsuranceCompanyCity	payor
InsuranceCompanyIdentifier	extension('http://careevolution.com/fhirextensions#coverage-insuranceCompanyIdentifier')
InsuranceCompanyIdentifierType Domain: IdentifierType	extension('http://careevolution.com/fhirextensions#coverage-insuranceCompanyIdentifierType')
InsuranceCompanyName	payor
InsuranceCompanyPhone	payor
InsuranceCompanyPostalCode	payor
InsuranceCompanyState	payor
InsuredAddress	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredAddress')
InsuredAltPhone	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredAltPhone')
InsuredCity	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredAddress')
InsuredDob	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredDob')
InsuredGender	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredGender')
InsuredName	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredName')
InsuredPhone	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredPhone')
InsuredPostalCode	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredAddress')
InsuredRelationship Domain: FamilyRelationship	relationship Bindings:  valueset-subscriber-relationship
InsuredSsn	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredSsn')
InsuredState	subscriber
	extension('http://careevolution.com/fhirextensions#coverage-insuredAddress')
MedicaidCaseName	extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseName')
MedicaidCaseNumber	extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseNumber')
MedicareCardNumber	extension('http://careevolution.com/fhirextensions#coverage-medicareCardNumber')
Network Domain: InsuranceNetwork	network
PatientID	beneficiary
PharmacyCoverage	extension('http://careevolution.com/fhirextensions#coverage-pharmacyCoverage')
PlanIdentifier	identifier
PlanName	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|plan
PlanType Domain: InsurancePlanType	type
PolicyNumber	extension('http://careevolution.com/fhirextensions#coverage-policyNumber')
PrimaryCaregiver	extension('http://careevolution.com/fhirextensions#coverage-primaryCaregiver')
Priority	order
Product Domain: InsuranceProduct	class	Maps the class with type=http://careevolution.com/fhir/CoverageClass|product
ProductGroup Domain: InsuranceProductGroup	class	Maps the class with type=http://careevolution.com/fhir/CoverageClass|productgroup
Properties	extension('http://careevolution.com/fhirextensions#properties')
Property('Dependent')	dependent
Property('Sequence')	extension('http://careevolution.com/fhirextensions#coverage-sequence')
Property('SusbcriberIdentifier')	subscriberId
RateCode Domain: InsuranceRateCode	extension('http://careevolution.com/fhirextensions#coverage-rateCode')
Segment Domain: InsuranceSegment	extension('http://careevolution.com/fhirextensions#coverage-segment')
Site	extension('http://careevolution.com/fhirextensions#coverage-site')
Sponsor	extension('http://careevolution.com/fhirextensions#coverage-sponsor')
StartDate	period
Status Domain: InsuranceStatus	status Bindings:  valueset-fm-status
Type Domain: InsuranceType	extension('http://careevolution.com/fhirextensions#coverage-type')

From FHIR mappings

CareEvolution	FHIR
AuthorizationDate	extension('http://careevolution.com/fhirextensions#coverage-authorizationDate')
AuthorizationNumber	extension('http://careevolution.com/fhirextensions#coverage-authorizationNumber')
AuthorizationSource	extension('http://careevolution.com/fhirextensions#coverage-authorizationSource')
Class Domain: InsuranceClass	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|class
Comment	text
DataSource	extension('http://careevolution.com/fhirextensions#dataSource')
EncounterID	extension('http://careevolution.com/fhirextensions#coverage-encounterID')
EndDate	period
GroupEmpId	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|subplan
GroupEmpName	extension('http://careevolution.com/fhirextensions#coverage-groupEmpName')
GroupName	extension('http://careevolution.com/fhirextensions#coverage-groupName')
	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|subgroup
GroupNumber	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|group
InsuranceCompanyAddress	payor
InsuranceCompanyCity	payor
InsuranceCompanyIdentifier	extension('http://careevolution.com/fhirextensions#coverage-insuranceCompanyIdentifier')
InsuranceCompanyIdentifierType Domain: IdentifierType	extension('http://careevolution.com/fhirextensions#coverage-insuranceCompanyIdentifierType')
InsuranceCompanyName	payor
InsuranceCompanyPhone	payor
InsuranceCompanyPostalCode	payor
InsuranceCompanyState	payor
InsuredAddress	subscriber
InsuredAltPhone	subscriber
InsuredCity	subscriber
InsuredDob	subscriber
InsuredGender	subscriber
InsuredName	subscriber
InsuredPhone	subscriber
InsuredPostalCode	subscriber
InsuredRelationship Domain: FamilyRelationship	relationship Bindings:  valueset-subscriber-relationship
InsuredSsn	subscriber
InsuredState	subscriber
MedicaidCaseName	extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseName')
MedicaidCaseNumber	extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseNumber')
MedicareCardNumber	extension('http://careevolution.com/fhirextensions#coverage-medicareCardNumber')
Network Domain: InsuranceNetwork	network
PatientID	beneficiary
PharmacyCoverage	extension('http://careevolution.com/fhirextensions#coverage-pharmacyCoverage')
PlanIdentifier	identifier
	id
PlanName	class	Maps the class with type=http://terminology.hl7.org/CodeSystem/coverage-class|plan
PlanType Domain: InsurancePlanType	type
PolicyNumber	extension('http://careevolution.com/fhirextensions#coverage-policyNumber')
PrimaryCaregiver	extension('http://careevolution.com/fhirextensions#coverage-primaryCaregiver')
Priority	order
Product Domain: InsuranceProduct	class	Maps the class with type=http://careevolution.com/fhir/CoverageClass|product
ProductGroup Domain: InsuranceProductGroup	class	Maps the class with type=http://careevolution.com/fhir/CoverageClass|productgroup
Properties	extension('http://careevolution.com/fhirextensions#properties')
Property('Dependent')	dependent
Property('Sequence')	extension('http://careevolution.com/fhirextensions#coverage-sequence')
Property('SusbcriberIdentifier')	subscriberId
RateCode Domain: InsuranceRateCode	extension('http://careevolution.com/fhirextensions#coverage-rateCode')
Segment Domain: InsuranceSegment	extension('http://careevolution.com/fhirextensions#coverage-segment')
Site	extension('http://careevolution.com/fhirextensions#coverage-site')
Sponsor	extension('http://careevolution.com/fhirextensions#coverage-sponsor')
StartDate	period
Status Domain: InsuranceStatus	status Bindings:  valueset-fm-status
Type Domain: InsuranceType	extension('http://careevolution.com/fhirextensions#coverage-type')

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